title: Health-Related Quality of Life in HIV-Infected and At-Risk Women: The Impact of Illicit Drug Use and Hepatitis C on a Community Preference Weighted Measure.
abstract: To assess the impact of illicit drug use and chronic hepatitis C virus (HCV) on health-related quality of life (HRQoL) in women with HIV or at risk for HIV infection.
  
  
  
  Cross-sectional analysis of data from the Women's Interagency Health Study (WIHS) of women with HIV (n = 2508) and at high risk of HIV infection (n = 889) in the US. A Short-Form-6D (SF-6D) HRQoL measure derived from the Medical Outcomes Study-HIV (MOS-HIV) questionnaire, HIV infection status, CD4 cell count (a measure of immune status), antiretroviral treatment, current illicit drug use (heroin and/or cocaine), and HCV status were assessed at a recent study visit. We developed multivariate linear regression models adjusting for age, race/ethnicity, education, and testing for interactions.
  
  
  
  HIV-infected women with ≤200 CD4 cells/µL had lower mean HRQoL scores (0.69) than either HIV-infected women with >200 CD4 cells/µL (0.78) or HIV-uninfected women (0.80) (P < 0.01). In multivariate analysis, illicit drug use, chronic HCV, and low CD4 count were independently associated with lower HRQoL. There was a differential effect of HCV and illicit drug use for HIV-infected women depending on CD4 cell count: HIV-infected women with >200 CD4 cells/µL had a significantly greater reduction in HRQoL associated with illicit drug use (-0.063) and chronic HCV (-0.036) than women with ≤200 CD4 cells/µL (-0.017, -0.005 respectively).
  
  
  
  Poorly controlled HIV, illicit drug use, and chronic HCV are associated with lower HRQoL. Illicit drug use and chronic HCV have greater HRQoL impacts for HIV-infected women with well-controlled HIV versus those with poorly controlled HIV, which may affect clinical and policy priorities.
authors.affiliation: Department of Public Health, Weill Cornell Medical College, New York, NY (BA, BRS)
authors.forename: Brandon
authors.initials: B
authors.lastname: Aden
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada (BN)|Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada (BN)
authors.forename: Bohdan
authors.initials: B
authors.lastname: Nosyk
authors.affiliation: Center for Health Decision Science, Harvard School of Public Health, Boston, MA (EW).
authors.forename: Eve
authors.initials: E
authors.lastname: Wittenberg
authors.affiliation: Department of Public Health, Weill Cornell Medical College, New York, NY (BA, BRS)
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Schackman
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D006526:Hepatitis C / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; health utility; health-related quality of life; hepatitis C virus; illicit drug use; opiate dependence